II 

118TH CONGRESS 

2D SESSION S. 5141 

To provide for health coverage with no cost-sharing for additional breast 

screenings for certain individuals at greater risk for breast cancer. 

IN THE SENATE OF THE UNITED STATES 

SEPTEMBER 23, 2024 

Ms. KLOBUCHAR (for herself and Mr. MARSHALL) introduced the following 

bill; which was read twice and referred to the Committee on Health, Education, Labor, and Pensions 

A BILL 

To provide for health coverage with no cost-sharing for additional breast screenings for certain individuals at greater 

risk for breast cancer. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Find It Early Act’’. 


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1 SEC. 2. COVERAGE WITH NO COST-SHARING FOR ADDI2 TIONAL BREAST SCREENINGS FOR CERTAIN 

3 INDIVIDUALS AT GREATER RISK FOR BREAST 

4 CANCER. 

5 (a) COVERAGE UNDER GROUP HEALTH PLANS AND

6 GROUP AND INDIVIDUAL HEALTH INSURANCE COV7 ERAGE.— 

8 (1) IN GENERAL.—Section 2713(a) of the Pub9 lic Health Service Act (42 U.S.C. 300gg–13(a)) is 

10 amended— 

11 (A) in paragraph (2), by striking ‘‘and’’ at 

12 the end; 

13 (B) in paragraph (3), by striking the pe14 riod at the end and inserting a semicolon; 

15 (C) in paragraph (4), by striking the pe16 riod at the end and inserting ‘‘and as described 

17 in subparagraph (E); and’’; 

18 (D) by redesignating paragraphs (1) 

19 through (5) as subparagraphs (A) through (E), 

20 respectively, and adjusting the margins accord21 ingly; 

22 (E) by striking the subsection designation 

23 and heading and all that follows through ‘‘A 

24 group health plan’’ and inserting the following: 

25 ‘‘(a) REQUIREMENTS.— 

26 ‘‘(1) IN GENERAL.—A group health plan’’; 


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1 (F) in the undesignated matter following 

2 subparagraph (E) of paragraph (1) (as so re3 designated), by striking ‘‘Nothing in this sub4 section’’ and inserting the following: 

5 ‘‘(3) RULE OF CONSTRUCTION.—Nothing in 

6 this subsection’’; 

7 (G) in subparagraph (E) of paragraph (1) 

8 (as so redesignated), by striking ‘‘(E) for the 

9 purposes of this Act,’’ and inserting the fol10 lowing: 

11 ‘‘(2) RECOMMENDATIONS.—For the purposes of 

12 this Act,’’; 

13 (H) in paragraph (1) (as so redesignated), 

14 by adding at the end the following: 

15 ‘‘(E)(i) with respect to an individual who is 

16 at increased risk of breast cancer (as deter17 mined in accordance with the most recent appli18 cable American College of Radiology Appro19 priateness Criteria or the most recent applicable 

20 guidelines of the National Comprehensive Can21 cer Network) or with heterogeneously or ex22 tremely dense breast tissue (as defined by the 

23 Breast Imaging Reporting and Data System es24 tablished by the American College of Radi25 ology), screening and diagnostic imaging (with 


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1 no limitation applied on frequency) for the de2 tection of breast cancer, including 2D or 3D 

3 mammograms, breast ultrasounds, breast mag4 netic resonance imaging, molecular breast imag5 ing, or other technologies (as determined in ac6 cordance with such applicable criteria or guide7 lines); and 

8 ‘‘(ii) with respect to an individual who is 

9 not described in subparagraph (A) and who is 

10 determined by a health care provider (in ac11 cordance with such most recent applicable cri12 teria or guidelines) to require screening or diag13 nostic breast imaging by reason of factors, in14 cluding age, race, ethnicity, or personal or fam15 ily medical history, screening and diagnostic im16 aging (with no limitation applied on frequency) 

17 for the detection of breast cancer, including 2D 

18 or 3D mammograms, breast ultrasounds, breast 

19 magnetic resonance imaging, molecular breast 

20 imaging, or other technologies (as determined 

21 in accordance with such applicable criteria or 

22 guidelines).’’. 

23 (2) EFFECTIVE DATE.—The amendments made 

24 by paragraph (1) shall apply with respect to plan 

25 years beginning on or after January 1, 2025. 


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1 (3) APPLICATION TO GRANDFATHERED HEALTH

2 PLANS.—Section 1251(a)(4)(A) of the Patient Pro3 tection and Affordable Care Act (42 U.S.C. 

4 18011(a)(4)(A)) is amended— 

5 (A) by striking ‘‘title)’’ and inserting 

6 ‘‘title, or as added after the date of the enact7 ment of this Act)’’; 

8 (B) by redesignating clause (iv) as clause 

9 (v); and 

10 (C) by inserting after clause (iii) the fol11 lowing: 

12 ‘‘(iv) Section 2713(a)(1)(E) (relating 

13 to screening and diagnostic imaging for the 

14 detection of breast cancer).’’. 

15 (b) COVERAGE UNDER MEDICARE.— 

16 (1) IN GENERAL.—Section 1861(ddd)(1)(B) of 

17 the Social Security Act (42 U.S.C. 

18 1395x(ddd)(1)(B)) is amended— 

19 (A) by striking ‘‘(B) recommended’’ and 

20 inserting ‘‘(B)(i) recommended’’; 

21 (B) by striking ‘‘Task Force; and’’ and in22 serting ‘‘Task Force; or’’; and 

23 (C) by adding at the end the following new 

24 clause: 


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1 ‘‘(i) beginning on January 1, 2025, in addition 

2 to any other items or services described in this para3 graph, screening and diagnostic imaging (with no 

4 limitation applied on frequency) for the detection of 

5 breast cancer, including 2D or 3D mammograms, 

6 breast ultrasounds, breast magnetic resonance imag7 ing, molecular breast imaging, or other technologies 

8 (as determined in accordance with the most recent 

9 applicable American College of Radiology Appro10 priateness Criteria or the most recent applicable 

11 guidelines of the National Comprehensive Cancer 

12 Network) for— 

13 ‘‘(I) an individual who is at increased risk 

14 of breast cancer (as determined in accordance 

15 with such applicable criteria or guidelines) or 

16 with heterogeneously or extremely dense breast 

17 tissue (as defined by the Breast Imaging Re18 porting and Data System established by the 

19 American College of Radiology); and 

20 ‘‘(II) an individual who is not described in 

21 subclause (I) and who is determined by a health 

22 care provider (in accordance with such most re23 cent applicable criteria or guidelines) to require 

24 such screening or diagnostic breast imaging by 

25 reason of factors determined by the Secretary, 


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1 including age, race, ethnicity, or personal or 

2 family medical history; and’’. 

3 (2) APPLICATION OF NO COST-SHARING UNDER

4 MEDICARE ADVANTAGE PLANS.—Section 

5 1852(a)(1)(B) of the Social Security Act (42 U.S.C. 

6 1395w–22(a)(1)(B)) is amended— 

7 (A) in clause (iv)— 

8 (i) by redesignating subclause (VIII) 

9 as subclause (IX); and 

10 (ii) inserting after subclause (VII) the 

11 following: 

12 ‘‘(VIII) Beginning on January 1, 

13 2024, screening and diagnostic imag14 ing and other technologies described 

15 in section 1861(ddd)(1)(B)(ii) fur16 nished to an individual described in 

17 such section.’’; and 

18 (B) in clause (v), by striking ‘‘and (VI)’’ 

19 and inserting ‘‘(VI), and (VIII)’’. 

20 (c) COVERAGE UNDER MEDICAID.— 

21 (1) IN GENERAL.—Section 1905(a) of the So22 cial Security Act (42 U.S.C. 1396d(a)) is amend23 ed— 

24 (A) in paragraph (4)— 


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1 (i) by striking ‘‘; and (D)’’ and insert2 ing ‘‘; (D)’’; 

3 (ii) by striking ‘‘; and (E)’’ and in4 serting ‘‘; (E)’’; 

5 (iii) by striking ‘‘; and (F)’’ and in6 serting ‘‘; (F)’’; and 

7 (iv) by inserting before the semicolon 

8 at the end the following: ‘‘; and (G)(i) with 

9 respect to an individual who is at increased 

10 risk of breast cancer (as determined in ac11 cordance with the most recent applicable 

12 American College of Radiology Appro13 priateness Criteria or the most recent ap14 plicable guidelines of the National Com15 prehensive Cancer Network) or with het16 erogeneously or extremely dense breast tis17 sue (as defined by the Breast Imaging Re18 porting and Data System established by 

19 the American College of Radiology), in ad20 dition to any other item or service de21 scribed in this subsection, screening and 

22 diagnostic imaging (with no limitation ap23 plied on frequency) for the detection of 

24 breast cancer, including 2D or 3D mam25 mograms, breast ultrasounds, breast magVerDate Sep 11 2014 07:21 Oct 04, 2024 Jkt 059200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\S5141.IS S5141

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1 netic resonance imaging, molecular breast 

2 imaging, or other technologies (as deter3 mined in accordance with such applicable 

4 criteria or guidelines); and (ii) with respect 

5 to an individual who is not described in 

6 clause (i) and who is determined by a 

7 health care provider (in accordance with 

8 such most recent applicable criteria or 

9 guidelines) to require screening or diag10 nostic breast imaging by reason of factors, 

11 including age, race, ethnicity, or personal 

12 or family medical history, screening and di13 agnostic imaging (with no limitation ap14 plied on frequency) for the detection of 

15 breast cancer, including 2D or 3D mam16 mograms, breast ultrasounds, breast mag17 netic resonance imaging, molecular breast 

18 imaging, or other technologies (as deter19 mined in accordance with such applicable 

20 criteria or guidelines)’’; and 

21 (B) in paragraph (13), in the matter pre22 ceding subparagraph (A), by inserting ‘‘(other 

23 than an item or service for which medical as24 sistance is provided pursuant to paragraph 

25 (4)(G))’’ after ‘‘services’’. 


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1 (2) NO COST-SHARING FOR CERTAIN BREAST

2 CANCER SCREENING AND DIAGNOSTIC IMAGING.— 

3 (A) IN GENERAL.—Subsections (a)(2) and 

4 (b)(2) of section 1916 of the Social Security 

5 Act (42 U.S.C. 1396o(a)(2)(D)) are each 

6 amended— 

7 (i) in the last subparagraph, by strik8 ing at the end ‘‘; and’’ and inserting ‘‘, 

9 or’’; and 

10 (ii) by adding at the end the following 

11 subparagraph: 

12 ‘‘(K) with respect to an individual de13 scribed in clause (i) or (ii) of section 

14 1905(a)(4)(G), screening and diagnostic imag15 ing and other technologies described in such 

16 clause (i) or (ii), respectively; and’’. 

17 (B) APPLICATION TO ALTERNATIVE COST18 SHARING.—Section 1916A(b)(3)(B) of the So19 cial Security Act (42 U.S.C. 1396o–1(b)(3)(B)) 

20 is amended by adding at the end the following 

21 new clause: 

22 ‘‘(xv) With respect to an individual 

23 described in clause (i) or (ii) of section 

24 1905(a)(4)(G), screening and diagnostic 


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1 imaging and other technologies described 

2 in such clause (i) or (ii), respectively.’’. 

3 (3) INCLUSION IN BENCHMARK COVERAGE.— 

4 Section 1937(b) of the Social Security Act (42 

5 U.S.C. 1396u–7(b)) is amended by adding at the 

6 end the following new paragraph: 

7 ‘‘(9) COVERAGE OF CERTAIN BREAST CANCER

8 SCREENING AND DIAGNOSTIC IMAGING FOR CERTAIN

9 INDIVIDUALS.—Notwithstanding the previous provi10 sions of this section, a State may not provide for 

11 medical assistance through enrollment of an indi12 vidual with benchmark coverage or benchmark-equiv13 alent coverage under this section unless such cov14 erage includes medical assistance, with respect to an 

15 individual described in clause (i) or (ii) of section 

16 1905(a)(4)(G), for screening and diagnostic imaging 

17 and other technologies described in such clause (i) or 

18 (ii), respectively.’’. 

19 (4) EFFECTIVE DATE.— 

20 (A) IN GENERAL.—Except as provided in 

21 subparagraph (B), the amendments made by 

22 this subsection shall take effect on January 1, 

23 2024. 

24 (B) DELAY PERMITTED IF STATE LEGISLA25 TION REQUIRED.—In the case of a State plan 


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1 approved under title XIX of the Social Security 

2 Act which the Secretary of Health and Human 

3 Services determines requires State legislation 

4 (other than legislation appropriating funds) in 

5 order for the plan to meet the additional re6 quirements imposed by this section, the State 

7 plan shall not be regarded as failing to comply 

8 with the requirements of such title solely on the 

9 basis of the failure of the plan to meet such ad10 ditional requirements before the first day of the 

11 first calendar quarter beginning after the close 

12 of the first regular session of the State legisla13 ture that ends after the 1-year period beginning 

14 with the date of the enactment of this section. 

15 For purposes of the preceding sentence, in the 

16 case of a State that has a 2-year legislative ses17 sion, each year of the session is deemed to be 

18 a separate regular session of the State legisla19 ture. 

20 (d) COVERAGE AND ELIMINATION OF COST-SHARING

21 UNDER TRICARE.— 

22 (1) COVERAGE.—Title 10, United States Code, 

23 is amended— 

24 (A) in section 1074d(a), by adding at the 

25 end the following new paragraph: 


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1 ‘‘(3) Any member or former member of the uniformed 

2 services who is entitled to medical care under section 1074 

3 or 1074a of this title and is an individual described in 

4 subparagraph (B) of section 1079(a)(20) of this title shall 

5 also be entitled to the items and services described in sub6 paragraph (A) of such section (subject to the same limita7 tions specified in such subparagraph), as part of such 

8 medical care.’’; and 

9 (B) in section 1079(a), by adding at the 

10 end the following new paragraph: 

11 ‘‘(20)(A) Screening and diagnostic imaging 

12 (with no limitation applied on frequency) for the de13 tection of breast cancer, including 2D or 3D mam14 mograms, breast ultrasounds, breast magnetic reso15 nance imaging, molecular breast imaging, or other 

16 technologies (as determined in accordance with the 

17 most recent applicable criteria or guidelines de18 scribed in subparagraph (B)), shall be provided if 

19 the patient is an individual described in subpara20 graph (B). 

21 ‘‘(B) An individual described in this subpara22 graph is— 

23 ‘‘(i) an individual who is at increased risk 

24 of breast cancer (as determined in accordance 

25 with the most recent applicable American ColVerDate Sep 11 2014 07:21 Oct 04, 2024 Jkt 059200 PO 00000 Frm 00013 Fmt 6652 Sfmt 6201 E:\BILLS\S5141.IS S5141

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1 lege of Radiology Appropriateness Criteria or 

2 the most recent applicable guidelines of the Na3 tional Comprehensive Cancer Network) or with 

4 heterogeneously or extremely dense breast tis5 sue (as defined by the Breast Imaging Report6 ing and Data System established by the Amer7 ican College of Radiology); or 

8 ‘‘(ii) an individual who is not described in 

9 clause (i) and who is determined by a health 

10 care provider (in accordance with such most re11 cent applicable criteria or guidelines) to require 

12 screening or diagnostic breast imaging by rea13 son of factors including age, race, ethnicity, or 

14 personal or family medical history.’’. 

15 (2) ELIMINATION OF COST-SHARING.—Such 

16 title is further amended— 

17 (A) in section 1075a, by adding at the end 

18 the following new subsection: 

19 ‘‘(d) ELIMINATION OF COST-SHARING FOR CERTAIN

20 BREAST CANCER-RELATED ITEMS AND SERVICES.—Not21 withstanding any other provision of this section, cost-shar22 ing requirements may not be imposed or collected with re23 spect to any beneficiary enrolled in TRICARE Prime for 

24 any item or service described in subparagraph (A) of sec25 tion 1079(a)(20) of this title provided under TRICARE 


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1 Prime, in accordance with the limitations specified in such 

2 subparagraph, if the beneficiary is an individual described 

3 in subparagraph (B) of such section.’’; 

4 (B) in section 1075(c), by adding at the 

5 end the following new paragraph: 

6 ‘‘(4) Notwithstanding any other provision of 

7 this section, cost-sharing requirements may not be 

8 imposed or collected with respect to any beneficiary 

9 enrolled in TRICARE Select for any item or service 

10 described in subparagraph (A) of section 

11 1079(a)(20) of this title provided under TRICARE 

12 Select, in accordance with the limitations specified in 

13 such subparagraph, if the beneficiary is an indi14 vidual described in subparagraph (B) of such sec15 tion.’’; and 

16 (C) in section 1086(d)(3)— 

17 (i) by redesignating subparagraph (C) 

18 as subparagraph (D); and 

19 (ii) by inserting after subparagraph 

20 (B) the following new subparagraph: 

21 ‘‘(C) Notwithstanding any other provision of this sec22 tion, cost-sharing may not be imposed or collected under 

23 a plan contracted for under subsection (a) with respect 

24 to any individual described in subparagraph (B) of section 

25 1079(a)(20) of this title for an item or service described 


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1 in subparagraph (A) of such section and provided in ac2 cordance with the limitations specified in such subpara3 graph.’’. 

4 (3) EFFECTIVE DATE.—The amendments made 

5 by this subsection shall take effect on January 1, 

6 2025. 

7 (e) COVERAGE AND ELIMINATION OF COST-SHARING

8 WITH RESPECT TO VETERANS.— 

9 (1) COVERAGE AND ELIMINATION OF COST10 SHARING.—Subchapter II of chapter 17 of title 38, 

11 United States Code, is amended by inserting after 

12 section 1720J the following new section: 

13 ‘‘§ 1720K. Breast screenings for certain individuals at 

14 increased risk for breast cancer 

15 ‘‘(a) COVERAGE OF ITEMS AND SERVICES.— 

16 ‘‘(1) COVERAGE.—The Secretary shall furnish 

17 to a veteran described in paragraph (2) screening 

18 and diagnostic imaging (with no limitation applied 

19 on frequency) for the detection of breast cancer, in20 cluding 2D or 3D mammograms, breast ultrasounds, 

21 breast magnetic resonance imaging, molecular breast 

22 imaging, or other technologies (as determined in ac23 cordance with the most recent applicable criteria or 

24 guidelines described in such paragraph) pursuant to 

25 this section. 


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1 ‘‘(2) ELIGIBILITY.—A veteran described in this 

2 paragraph is— 

3 ‘‘(A) a veteran who is at increased risk of 

4 breast cancer (as determined in accordance with 

5 the most recent applicable American College of 

6 Radiology Appropriateness Criteria or the most 

7 recent applicable guidelines of the National 

8 Comprehensive Cancer Network) or with het9 erogeneously or extremely dense breast tissue 

10 (as defined by the Breast Imaging Reporting 

11 and Data System established by the American 

12 College of Radiology), without regard to wheth13 er the veteran is enrolled in the system of an14 nual patient enrollment established under sec15 tion 1705(a) of this title; or 

16 ‘‘(B) a veteran who is not described in sub17 paragraph (A) and who is determined by a 

18 health care provider (in accordance with such 

19 most recent applicable criteria or guidelines) to 

20 require screening or diagnostic breast imaging 

21 by reason of factors including age, race, eth22 nicity, or personal or family medical history, 

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1 ment established under section 1705(a) of this 

2 title. 

3 ‘‘(b) PROHIBITION ON COST-SHARING.—Notwith4 standing subsections (f) and (g) of section 1710 and sec5 tion 1722A of this title, the Secretary may not require 

6 any veteran described in paragraph (2) of subsection (a) 

7 to make any copayment for, or charge the veteran for any 

8 other cost of, the receipt of any item or service furnished 

9 pursuant to paragraph (1) of such subsection.’’. 

10 (2) CLERICAL AMENDMENT.—The table of sec11 tions at the beginning of such chapter is amended 

12 by inserting after the item relating to section 1720J 

13 the following new item: 

‘‘1720K. Breast screenings for certain individuals at increased risk for breast 

cancer.’’. 

14 (3) EFFECTIVE DATE.—The amendments made 

15 by this subsection shall take effect on January 1, 

16 2025. 

Æ 


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